Reconstructive treatment of patients with deep sternal infection

The authors, based on the materials of russian and foreign researchers, give a short review of the development of sternal osteosynthesis and chest wall reconstruction after treatment of deep sternal wound infection. Reliable fixation of sternum fragments plays a leading role in the prevention of relapses of sternomediastinitis. The methods used for sternotomy re-closure vary from wire sternal suture in various ways to using rigid plate fixation by screws, thermoreactive clips and the sternal ZipFix™ system. The choice of the method of plastic surgery of the anterior chest wall depends on the general condition of the patient, the nature of the concomitant pathology, the volume of purulent-destructive damage to the surrounding tissues, the radicality of the previous surgical treatment, as well as on the experience and specialization of the surgeon. The article emphasizes the priority of the plastic reserve of local tissues with the participation of pectoralis major muscle flaps, the limitation of indications for omentoplasty.